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高屈曲假体初次全膝关节置换术早期随访结果的Meta分析 被引量:5

High-flexion implants in primary total knee arthroplasty: a meta-analysis
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摘要 目的 分析有关高屈曲假体与普通假体初次全膝关节置换术后疗效比较的文献,对术后关节活动度(range of motion,ROM)及膝关节功能评分(HSS、KSS、WOMAC)进行Meta分析.方法 检索Medline(1966年1月至2009年10月),Embase(1966年1月至2009年10月),维普资讯(1989年1月至2009年10月)和CNKI(1979年1月至2009年10月)等数据库中关于高屈曲假体与普通假体在初次伞膝关节置换术中应用的疗效比较的前瞻性随机对照研究,纳人符合标准的文献,提取相关数据输入Review Manager 4.2软件进行统计学分析.术后ROM和膝关节功能评分均采取权重均差(weighted mean difference,WMD)进行评价.结果 共6篇文献符合纳入标准,经改良Jadad评分均判定为高质量研究.纳入病例466例,高屈曲假体组和普通假体组术后ROM合并WMD为1.64195%C1(-0.04,3.32),P=0.06],膝关节HSS评分合并WMD为0.34[95%CI(-1.12,1.79),P=0.65],膝关节KSS评分合并WMD为-0.67[95%CI(-2.22,0.89),P=0.40],膝关节WOMAC评分合并WMD为1.66195%C1(-4.03,7.35),P=0.57].高屈曲假体组与普通假体组的ROM、HSS、KSS、WOMAC的差异无统计学意义.结论 初次全膝关节置换术后高屈曲假体组相比普通假体组ROM无明显改善,膝关节功能评分无明显差异. Objective To evaluate the clinical effects between high-flexion and conventional im-plants in primary total knee arthroplasty using the method of meta analysis on range of motion (ROM) and knee function scores (HSS, KSS, WOMAC). Methods A computer-based online search of Pubmed (1966.1-2009.10), Embase (1966.1-2009.10), VIP (1989.1-2009.10) and CNKI (1979.1-2009.10) were performed to collect RCTs and comparison observational studies of comparing high-flexion and conventional knee im-plants. The papers met the criteria were collected, and then extracted the data of ROM and functional out-comes, which were evaluated by Review Manager 4.2 for meta analysis. The weighted mean difference (WMD) method was used with 95%CI. Results A total of 6 studies (466 patients) met our inclusion criteria and all of them were high quality studies. The combined WMD of postoperative ROM between high-flexion and conventional implants was 1.64 [95%CI (-0.04, 3.32), P=0.06], the combined WMD of HSS scores was 0.34[95%CI(-1.12, 1.79), P=0.651, the combined WMD of KSS scores was -0.67[95%C/(-2.22, 0.89), P= 0.40], and the combined WMD of WOMAC scores was 1.66 [95%CI (-4.03, 7.35), P=0.57]. There were no significant differences in the ROM, HSS, KSS, and WOMAC after operation between two groups. Conclusion High-flexion implant design dose not improve overall ROM as compared to traditional implants and offers no clinical advantage over conventional implant designs in primary total knee arthroplasty.
出处 《中华骨科杂志》 CAS CSCD 北大核心 2010年第6期548-553,共6页 Chinese Journal of Orthopaedics
关键词 关节成形术 置换 假体设计 META分析 Arthroplasty, replacement, knee Prosthesis design Meta-analysis
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参考文献26

  • 1Laubenthal KN,Smidt GL,Kettelkamp DB.A quantitative analysis of knee motion during activities of daily living.Phys Ther,1972,52(1):34-43.
  • 2Ritter MA,Harty LD,Davis KE,et al.Predicting range of motion after total knee arthroplasty.Clustering,log-linear regression,and regression tree analysis.J Bone Joint Surg (Am),2003,85(7):1278-1285.
  • 3Anouchi YS,MeShane M,Kelly F Jr.Range of motion in total knee replacement.Clin Orthop Relat Res,1996(331):87-92.
  • 4Schunnan DJ,Rojer DE.Total knee arthroplasty:range of motion across five systems.Clin Orthop Relat Res,2005(430):132-137.
  • 5Argenson JN,Komistek RD,Mahfouz M,et al.A high flexion total knee arthroplasty design replicates healthy knee motion.Clin Orthop Relat Res,2004(428):174-179.
  • 6Jadad AR,Moore RA,Carroll D,et al.Assessing the quality of reports of randomized clinical trials:is blinding necessary? Control Clin Trials,1996,17(1):1-12.
  • 7Egger M,Davey SG,Schneider M.Bias in meta-analysis detected by a simple,graphical test.BMJ,1997,315(7109):629-634.
  • 8Kim YH,Sohn KS.Kim JS.Range of motion of standard and high-flexion posterior stabilized total knee prostheses:a prospective,randomized study.J Bone Joint Surg (Am),2005,87(7):1470-1475.
  • 9Weeden SH,Schmidt R.A randomized,prospective study of primary total knee components designed for increased flexion.J Arthroplasty,2007,22(3):349-352.
  • 10Nutton RW,van der Linden ML,Rowe PJ,et al.A prospective randomised double-blind study of functional outcome and range of flexion following total knee replacement with the NexGen standard and high flexion components.J Bone Joint Surg (Br),2008,90(1):37-42.

二级参考文献10

  • 1Sultan PG,Most E,Schule S,et al.Optimizing flexion after total knee arthroplasty[J].Clin Orthop Relat Res,2003,(416):167-173.
  • 2Argenson JN,Scuderi GR,Komistek RD,et al.In vivo kinematic evaluation and design consideration related to high flexion in total knee arthroplasty[J].J biomech,2005,38(2):277-284.
  • 3Menke W,Schmitz B,Salm S.Range of motion after total condylar knee arthroplasty[J].Arch Orthop Trauma Surg,1992,111(5):280-281.
  • 4Ritter MA,Harty LD,Davis KE,et al.Predicting range of motion after total knee arthroplasty[J].J Bone Joint Surg Am,2003,85(7):1278-1284.
  • 5Shoji H,Solomonow M,Yoshino S,et al.Factors affecting post-operative flexion in total knee arthroplasty[J].Orthopedics,1990,13(6):643-649.
  • 6Ryu J,Saito S,Yamamoto K,et al.Factors influencing the post-operative range of motion in total knee arthroplasty[J].Bull Hosp Jt Dis,1993,53(3):35-40.
  • 7Masri BA,Laskin RS,Windsor RE,et al.Knee closure in total knee replacement:a randomized prospective trial[J].Clin Orthop Relat Res,1996,(331):81-86.
  • 8Emerson RH,Ayers C,Head WC,et al.Surgical closing in primary total knee arthroplasties:flexion versus extension[J].Clin Orthop Relat Res,1996,(331):74-80.
  • 9Lachiewicz PF.The role of continuous passive motion after total knee arthroplasty[J].Clin Orthop Relat Res,2000,(380):144-150.
  • 10Kumar PJ,McPherson EJ,Dorr LD,et al.Rehabilitation after total knee arthroplasty:a comparison of 2 rehabilitation techniques[J].Clin Orthop Relat Res,1996,(331):93-101.

共引文献2

同被引文献55

  • 1Banks S, Bellemans J, Nozaki H, et al. Knee motions during maximum flexion in fixed and mobile-bearing arthroplasties[J]. Clin Orthop Relat Res, 2003(410): 131-138.
  • 2Hanratty BM, Thompson NW, Wilson RK, et al. The influence of posterior condylar offset on knee flexion after total knee replacement using a cruciate-sacrificing mobile-bearing implant[J]. J Bone Joint Surg Br, 2007, 89(7): 915-918.
  • 3Ewald FC. 3he knee society total knee arthroplasty roentgenographic evaluation and scoring system[J]. Clin Orthop Relat Res, 1989(248): 9-12.
  • 4Gomes LS, Bechtold ]E, Gusti|o RB. Pate|lar prosthesis positioning in total knee arthroplasty. A roentgenographic study[J]. Clin Orthop Relat Res, 1988(236): 72-81.
  • 5Suggs JF, Kwon YM, Durbhakula SM, et al. In vivo flexion and kinematics of the knee after TKA: comparison of a conventional and a high flexion cruciate-retaining TKA design[J]. Knee Surg Sports Traumatol Arthrosc, 2009, 17(2): 150-156.
  • 6Malik A, Salas A, Ben Ari J, et aI. Range of motion and function are similar in patients undergoing TKA with posterior stabilised and high-flexion inserts[J]. Int Orthop, 2010, 34(7): 965-972.
  • 7Seon JK, Park SJ, Lee KB, et al. Range of motion in total knee arthroplasty: a prospective comparison of high-flexion and standard cruciate-retaining designs[J]. J Bone Joint Surg Am, 2009, 91(3): 672-679.
  • 8Minoda Y, Aihara M, Sakawa A, et al. Range of motion of standard and high-flexion cruciate retaining total knee prostheses[J]. ] Arthroplasty, 2009, 24(5): 674-680.
  • 9Gupta SK, Ranawat AS, Shah V, et al. The PFC sigma RP-F TKA designed for improved performance: a matched-pair study[J]. Orthopedics, 2006, 29(9 Suppl): S49-S52.
  • 10Thomsen MG, Husted H, Otte KS, et al. Do patients care about higher flexion in total knee arthroplasty? A randomized, controlled, double-blinded trial[J]. BMC Musculoskelet Disord, 2013, 14(1): 127.

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